The Peyronie's Curve: Dr. Mistry On Diagnosis and Treatment At Any Age

Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Dr. Mistry and Donna Lee answer a listener's question on Peyronie's disease. If you have developed a bend in your penis or if, when erect, it stands at an unnatural angle, you may have Peyronie's disease. While the exact cause is unknown, Peyronie's disease may be caused by the slowly accumulating effects of microtrauma to the penis sustained during intercourse with a less-than-fully-erect penis. Scar tissue can develop along the penis shaft, causing the often painful and distressing changes associated with this incredibly common condition. More severe, acute trauma to the penis can also cause Peyronie's to develop practically overnight, so please be careful when having vigorous intercourse--the most common cause of serious penile trauma.

Fortunately, there are many treatments for Peyronie's disease that address it's various causes and effects. In this episode, Dr. Mistry explains why anyone who is sexually active is a candidate for Peyronie's disease treatment. There are different interventions depending on the degree of penile curvature and the severity of symptoms. While people with a lower degree of curvature might benefit from Xiaflex injections, those with more severe curves should consider one of the surgical options offered by NAU Urology Specialists. No matter your disease progression, getting an evaluation and proper measurement of your curvature by a urologist is essential in identifying the right treatment. 

If you enjoyed today’s episode, don’t forget to like, subscribe, and share us with a friend! As always, be well!

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1 0:09

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry 0:17

Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my professional comedienne and practice guru Donna Lee.

Donna Lee 0:26

That's right. I hope comedy comes back to the world again sometime soon after this pandemic.

Dr. Mistry 0:29

Yes, I think they're moving one of our favorite comedy places to the Domain.

Donna Lee 0:33

I saw that. Cap City Comedy will go to the Domain.

Dr. Mistry 0:36

It'll be sophisticated. We're going to have a glass of wine.

Donna Lee 0:40

It'll cost more to get in.

Dr. Mistry 0:40

Oh crap. We won't be able to park right out in front anymore.

Donna Lee 0:43

That's right. You can just listen to your comedy on the show. How about that?

Dr. Mistry 0:45

I'm Dr. Mystery. I am a board certified urologist. That is my real name.

Donna Lee 0:50

M-I-S-T-R-Y.

Dr. Mistry 0:52

That is not, I don't think it's gimmicky.

Donna Lee 0:53

We're still not getting past that. Does that guy still talk to you?

Dr. Mistry 0:56

Man. That was like the second week of the show.

Donna Lee 0:59

He said in an email,"I wish y'all, didn't use such a gimmicky last name, but then I realized it was your real last name."

Dr. Mistry 1:05

Okay. Well, good. Well, that is my real last name. I am a board certified urologist. This show is brought to you by the urology practice I started in 2007 right here in Austin, Texas. You can listen to this show on KLBJ news radio, as many of you probably are, but you can also catch us on the podcast.

Donna Lee 1:22

Dr. Worldwide is known as the most famous medical podcaster ever.

Dr. Mistry 1:27

Yes. I feel like this show is all about me, but in fact, Donna, you do this show sometimes without me.

Donna Lee 1:32

I do, because I set it up that way for job security.

Dr. Mistry 1:34

And it's really just so that people will have something else interesting to listen to. It kind of hurts my feelings that some of the most downloaded podcasts are the ones that I'm not in it.

Donna Lee 1:42

Yeah, with Dr. Treadway and the other partners. The one we did with sexual issues, like sex injuries in the ER with Dr. Yang and his friend. Oh, Dr. Brenner. Yeah, that was one of our highest downloads.

Dr. Mistry 1:54

I feel like this is not fair. So those of you out there, just waiting for me to end so you can hear Donna, shame on you.

Donna Lee 2:00

I set this up so you can't fire me because if you fire me, then we don't have a show.

Dr. Mistry 2:03

That's right. That's right. That's why your face is so like prominently in the ads and everything.

Donna Lee 2:07

That's right. Welcome to my show, y'all.

Dr. Mistry 2:09

That's right. We are still seeing patients in a very safe way. We have offices all over town and Donna, how do people get ahold of us?

Donna Lee 2:17

You call us, and ask for me if you must and I will answer at(512) 238-0762. Our website is armormenshealth.com. And our email address is armormenshealth@gmail.com, where we will answer your questions. I respond as well to each email to let that person know that we'll send them a podcast. If they don't catch the show. Some people are sending us questions from like the other side of the world or the other side of the country. So keep reaching out to us. We'll send you the link as well. So we can answer your questions.

Dr. Mistry 2:41

We are getting a lot of patients from outside of Austin. So we are happily seeing you or talking to you. We're doing a lot of virtual telemedicine appointments, when it comes to some of the specialty services that we provide like shockwave or when it comes to high intensity focused ultrasound or other things that you may not have in your local community. So don't nervous.

Donna Lee 2:59

Have you heard how many shockwave commercials are on KLBJ?

Dr. Mistry 3:02

There's a lot of shockwave commercials.

Donna Lee 3:03

They're linear compression or spark wave. I mean, they're, they're all different names, but they're all basically the same function.

Dr. Mistry 3:10

If you want the best you come to us. So as I always say, if you want your erections treated, go to a doctor that treats erections. Don't, and that may sound silly, but that's where you should go. This idea, the idea of going to a wellness spa that does Botox for your eyebrows, and then also fixes your erections is silly.

Donna Lee 3:29

That is a little silly.

Dr. Mistry 3:31

That's right. And if you're going to a place that has like men's health institute on their website, but no real depth to it...I, you know, I mean, there may be some things to consider in terms of upgrading your care.

Donna Lee 3:41

Menpenis.com. We'll fix it.

Dr. Mistry 3:43

We'll fix it.

Donna Lee 3:44

Without a doctor.

Dr. Mistry 3:46

Yeah, without a plumber.

Donna Lee 3:46

That's true. That's scary. But that is such great marketing. I guess one of our employee's husbands said, why would a patient want to get injections in their penis for Peyronie's when they can just get one of those shockwave treatments, because that fixes everything? So...

Dr. Mistry 3:59

Yes, yes. I guess the marketing has worked.

Donna Lee 4:01

We need to let you guys know.

Dr. Mistry 4:02

Yeah, but we don't like to lie.

Donna Lee 4:03

You need to go to a doctor.

Dr. Mistry 4:04

You need to go to a doctor, this doctor. Donna, we love the questions in this practice that come to our show. And it really suggests a very high degree of engagement from our listeners. Donna, do you have a question for us?

Donna Lee 4:17

I do. I know we talked about 80 year old patients earlier in a different segment, but another one--80 year old man with BPH symptoms. He said, he actually called and spoke with me. He was very, very sweet. So he said his urologist did a physical prostate exam, which he hates, and told him to return in six months with no medication prescribed. He's going to get back with us with his PSA information. But he said, he's got about a 10 to 20 degree curvature with Peyronie's. And he also referenced that he heard the previous weekend where we talked about the gentlemen with the 60 degree curve. So he said nothing that extreme, but he wanted to know if we should address this at his age. He's at 80 years old. He said,"Do you think Dr. Mistry would want to talk about this in my age group?" And I said,"I'm sure Dr. Mistry's question will be,'Is the patient sexually active or does he want to be?'" He didn't really touch on that, but I can tell he's probably a little sexually active.

Dr. Mistry 5:04

Well, let me tell you he wouldn't care. Right? If he wasn't getting an erection, he couldn't see the curvature. So, because the curvature really only presents when erect. Right? So, so what I would say is that having an erection that is curved 10 to 20 degrees, there's some excellent, really, really low risk type things that can be done. If we measure it, because sometimes you underestimate it and the degree of curvature is 30 degrees or more, we can use those Xiaflex injections.

Donna Lee 5:31

How do you measure it?

Dr. Mistry 5:32

We actually have like this, this, this penis protract, the PP.

Donna Lee 5:35

It gets the penis erect in the clinic?

Dr. Mistry 5:37

Yeah. We can get the penis erect in the clinic.

Donna Lee 5:39

That's not, okay. I didn't know you could do that.

Dr. Mistry 5:41

But we can.

Donna Lee 5:42

Do you show them porn on the phone?

Dr. Mistry 5:45

No, we don't. We can give them a little something, a little something in the penis to give them a nice, rigid erection. Or we can just give them the little protractor and they can try it at home. And if over 30 degrees, then you're eligible for something called Xiaflex injections, which we do here in the office. But there's a lot of benefit from a, something that stretches the penis.

Donna Lee 6:07

The VED?

Dr. Mistry 6:07

No, there's the VED, but then we actually have something that actually just elongates and straightens the penis. In fact, if you use it, you can make your penis longer by an inch.

Donna Lee 6:17

Oh Lord, please. I hope Michael's not listening.

Dr. Mistry 6:19

He's probably wearing one right now.

Donna Lee 6:21

Take it off, Michael, take it off right now.

Dr. Mistry 6:23

I think I bought him one. So this, this was a little bait and switch of a question for this guy, because he started out like it was going to be a prostate question and least slipped the Peyronie's question in there. And what's funny is Peyronie's does make up the most commonly asked question that we have. It just leads me to believe there's a lot of guys out there with curved penises.

Donna Lee 6:42

Supposed to be 1 in 10. It's like 8 in 10.

Dr. Mistry 6:45

It's like 8 in 10 of our people. You should come in and let me talk to you. We can, if it's painful, we can do shockwave. If it's not painful, we can do Xiaflex. If it's severely debilitating, we can do surgery. But don't be afraid of these things. At least, at least be in the know, right? That's what that NBC little Saturday morning thing was. You know?

Donna Lee 7:02

The more you know.

Dr. Mistry 7:02

The more you know, the more you know, the more empowered you're being the better and better off you'll be. So certainly the age criterion doesn't, doesn't make a difference at all. Here's some things that are interesting to note: about 80% of men with Peyronie's disease have low testosterone.

Donna Lee 7:17

80%.

Dr. Mistry 7:18

That's right. To keep the Peyronie's from getting worse, you have to have a, we want you to keep a rigid penis.

Donna Lee 7:23

You can't see him, but Dr. Mistry's holding his fist and making that penis arm thing.

Dr. Mistry 7:27

But it is a little curved. I've had my wrist curved. That's right, I curved my wrist and making the visual. So if you're having sex and your penis is curved, you can just imagine just the, this, the tension that's being put on the penis is going to make you, it's going to make the curvature worse if you don't have a rigid penis. So almost all patients that have Peyronie's I put on a daily Tadalafil because I want them to have a rigid penis to enjoy sex and not make the curvature any worse.

Donna Lee 7:52

30 degree or more, or for...?

Dr. Mistry 7:54

Almost anyone, you know, because, one of the reasons that some, some scientists, researchers feel that Peyronie's exists is that it's because your erections are getting a little weaker. And then, so you start, you start pushing rope a little bit and that, and that, at, especially towards the end of intercourse, when you're having sex with a less than rigid penis, it's causing microtrauma to the penis, and then ultimately you Peyronie's disease. And so that, that is one proposed mechanism, because most people don't have like a massive like, event that occurs where their penis is just broken.

Donna Lee 8:29

Right. Over time.

Dr. Mistry 8:30

And it's usually a small type of trauma over time.

Donna Lee 8:32

So if you notice the tiniest of curvature, you should go see a urologist at that, at that moment?

Dr. Mistry 8:36

Good point. I don't think so. I think that, but if you notice that your curvature has changed or that it, or you feel like you're having to manipulate yourself to be able to like having intercourse, I think that that certainly is worthwhile of at least an exam, because the testosterone could be low. You could benefit from something to make your erections more rigid. And it'll you some peace of mind. And to the first part, I don't know very many men that enjoy the prostate exam. And so, if you, but to get your prostate examined, and I think PSA yearly, I think a prostate exam every so often are very good. And if you, if you are a particularly, you know, put off by doing an exam, then there are other things that we can potentially do. There are some blood tests that can give us additional information for PSA's. If your PSA is high, we can do a, an MRI of the prostate. We have other things. So when you're sitting there going,"Man, you know, the 21st century, don't we have a better way to do this than sticking a finger up...?" The answer is we do have some better ways to do things. You just have to ask.

Donna Lee 9:36

How long...when you put the finger in to check the prostate, that's just like an in and out kind of thing, right? It's not like you're in there for awhile.

Dr. Mistry 9:42

I mean, if you're an expert you're in there for just about, you know, 5 seconds.

Donna Lee 9:45

5 seconds. Okay. Cause I always thought you were in there for a long time.

Dr. Mistry 9:48

You did?

Donna Lee 9:49

I don't know.

Dr. Mistry 9:50

What did you think we were doing in there?

Donna Lee 9:50

I don't know. That's why I'm like, I'd be scared if I was a man. Because that as an exit only.

Dr. Mistry 9:54

There's not much else in there. Well, we would ask you to continue sending your questions, being engaged with the show, coming to see us as a patient. We love seeing patients. We have lots of availability. We're here to, you know, give you second opinions on your urologic issues. There's, there's rarely the patient who we see that we can't improve their care to some degree--whether it be in improving their nutrition, improving their supplement choices, giving them additional choices for treatment, and just giving them just added time so they understand their disease process better.

Donna Lee 10:28

That's right. You're not walking out of here, empty handed. That's what he's saying.

Dr. Mistry 10:30

That's right.

10:32

The Armor Men's Health Hour is brought to you by Urology Specialists. For questions, or to schedule an appointment, please call(512) 238-0762 or online at armormenshealth.com.